Ok ! You've done your homework. Your office looks like a page from Architectural Digest. Your staff has recently posed for Glamour Magazine and your doctors are the stand-ins for McDreamy and McSteamy.
You are definitely ready to take your show on the road. The question now is - Who will be your representative to the medical and patient community surrounding your practice?
Your first lesson is to assume that no one in your immediate area has even heard of your facility and act accordingly. You want to flood your market with name recognition and a strong understanding of the services that your practice offers. That means that you will have to develop strong bonds with physicians and residents of your areas and continue to market over and over again until you are sure that your target audience is aware of who and where you are.
Recent college graduates in the field of marketing and a select group of undergrad marketing students will be delighted to have the opportunity to hone their skills by marketing for your group. In the past, and especially in the current economic condition, these young people will often be willing to work for a small base salary and a commission based on the number of new patients and referring physicians that they bring to the practice. These newcomers to the field have unique skills and can provide a valuable asset to physicians looking to carry their message outside the office.
Marketing majors often have a good grasp on the computer software that will allow you to create most of your marketing materials in house and they know that pounding the pavement is a necessary part of their daily routine.
Before setting these employees loose, make sure you have them observe testing and procedures performed by your practice. They will need to understand the practice mission statement and the background of each physician. They should be able to answer any questions from prospective physician referrals or at least make provisions to get these answers to them as soon as possible.
Essential items that they should carry with them at all times will include:
Business cards for the practice.
A brochure outlining practice specialties.
Referral pads to leave with physicians.
Some small token items to leave with the front office - pens, note pads, magnets, mugs etc. ( It's all about name recognition)
For their first few visits, I would encourage that a member of your ancillary professional staff accompany them and judge their people skills and ability to convey your message. I have often used my echo or nuclear techs in this capacity on off schedule days and found it highly successful.
So many physicians have stopped marketing with all pharmaceutical and sales reps, so it won't be easy for your marketing staff to see them personally. In this case, they should be making strong contacts with the office managers or practice administrators and should follow up with them to make sure the physicians have seen any material provided during their visit. If you have the budget, you may want to provide a staff breakfast, luncheon, or desert tray for the prospective referring doctor or invite the office manager to lunch. Nothing gets to the heart of the matter better than a great tray of food !
In order to assess the efficiency of your marketing staff and to make sure they are not just parking at Dunkin Donuts or sleeping in their cars, they need to provide you with a list of physicians that they plan to market every day. They must bring back the business cards of each physician they met with or each office they visited, noting results. Each afternoon, they should return to the office and spend a few minutes with you, outlining their success or lack thereof and new strategies should be discussed. An additional responsibility is the tracking of referrals resulting from their efforts. A majority of their time must be spent in the field, rather than in the office and this should be made clear from their hire date. Require that they provide a business plan week to week and conduct scheduled marketing business meetings each month to discuss impressions and future plans.
Commercial insurers are placing a number of restrictions on testing that can be done by internists or family practitioners. These procedures are now authorized only for specialists. For example, if you are a cardiologist, you may want to send your echo tech to family practices and make them familiar with the services you provide and to assure them that appointments for echocardiograms are available to their patients either at your office or as part of a lease agreement where you would provide these services at their location and provide them with a monthly fee for leasing part of their space. In times like these where reimbursements are not what they once were, many practices welcome this influx of additional cash and the opportunity to keep their patients in house. Make sure you instill confidence in the family practitioner that you will not solicit the care of their patients and will see them only for services referred.
Your local hospital will usually offer monthly meetings to discuss administrative needs facing medical practices. Invitations to these meetings are made directly to the physician or office manager and attendance should be encouraged. Important contacts often result from these group sessions so take advantage of them whenever possible.
Tomorrow : Community Services
Friday, July 22, 2011
Thursday, July 21, 2011
Internal Marketing - Always Start Here !!
Marketing begins at home! Before you invest in any marketing campaign, take a long hard look at your office and your staff. Try to see what a patient will experience when they walk through the door. First and foremost, Is the office clean? I hate to cite this as the truth, but many patients will go to a subpar doctor with a beautiful decor, than a great doctor whose office looks like it was recently hit by a small tornado ! Look at your carpeting... Is it shredded and torn ? Are you exam room floors cleaned and polished ? Most of all, are your bathrooms clean? If not, don't waste your time on a marketing campaign, because even if you attract several new patients, chances are you won't have them for long..
Now look at your staff. Do they have a uniform, professional appearance? Six inch fingernails and nose rings might be cute at a club, but they have no place at the front desk. Medicine is now a consumer business and if you don't meet consumer needs and judgements, the office down the block or around the corner will. You may have an M.D. from Harvard and a P.H.D. from Yale, but if your office and staff look like a zombie film - you might want to consider investing in some storage space and look for another job...
One of the easiest ways to gauge the appearance of your office is to invite a brutally honest friend to pay a visit to your facility and give you their first impressions. Have this same individual call your practice with questions and requests for an appointment and gauge how long they waited on hold and if the staff was courteous and respectful.
Each member of your front office staff should be interchangeable with the next. They should all use the same greeting when answering the phone, know the waiting limits for appointments, especially if referrals or pre-certifications are needed, and be able to answer patient questions regarding tests and procedures with some degree of intelligence. If they are not doing all of the above right now, I suggest that you provide them with a set of cheat sheets and monitor their calls.
If your practice is suffering from any of these problems, you should first hold an after hours meeting with all the members of your staff. Clarify that the patient's first impression of the practice will last a lifetime and that every employee will be charged with the responsibility for presenting the practice in a positive light.
Suggest that all employees answer the phone with a smile on their faces. Smiling when speaking gives a positive tone to your voice. Unkempt hair or unwashed uniforms all send a message that you don't want associated with patient care. You may need to make a provision in your budget for a uniform allowance for your staff if they are not presenting a clean team look. Don't be afraid to challenge inappropriate jewelry or make-up and set a standard for a look that makes you proud to present your representatives. Loud voices, the use of obscenities, even in the employee kitchen, should be prohibited. Your office is dedicated to meeting patient needs and your employees all participate in the daily theatre for this goal.
Advise all employees that a clean, well kept office is everyone's responsibility. A piece of paper on the floor won't wait. Coffee pots and refrigerators should be cleaned daily, along with the restrooms, and if it takes a schedule to make it happen, then create a schedule and make sure it is followed. If your practice is doing well financially, consider hiring a cleaning person that comes in for a few hours each morning or evening. Not only will this be a marketing plus, it will also assure that germs are taken care of right away and lessen sick absences. If you cannot afford a professional, invest in some cleaning products, mops, brooms, and a good vacuum and make sure they are put to good use.
In short, put your best foot forward before venturing into the outside world. Every employee in your practice is involved in its marketing each and every day. It is your responsibility to assure that all staff members are doing their best.
Now look at your staff. Do they have a uniform, professional appearance? Six inch fingernails and nose rings might be cute at a club, but they have no place at the front desk. Medicine is now a consumer business and if you don't meet consumer needs and judgements, the office down the block or around the corner will. You may have an M.D. from Harvard and a P.H.D. from Yale, but if your office and staff look like a zombie film - you might want to consider investing in some storage space and look for another job...
One of the easiest ways to gauge the appearance of your office is to invite a brutally honest friend to pay a visit to your facility and give you their first impressions. Have this same individual call your practice with questions and requests for an appointment and gauge how long they waited on hold and if the staff was courteous and respectful.
Each member of your front office staff should be interchangeable with the next. They should all use the same greeting when answering the phone, know the waiting limits for appointments, especially if referrals or pre-certifications are needed, and be able to answer patient questions regarding tests and procedures with some degree of intelligence. If they are not doing all of the above right now, I suggest that you provide them with a set of cheat sheets and monitor their calls.
If your practice is suffering from any of these problems, you should first hold an after hours meeting with all the members of your staff. Clarify that the patient's first impression of the practice will last a lifetime and that every employee will be charged with the responsibility for presenting the practice in a positive light.
Suggest that all employees answer the phone with a smile on their faces. Smiling when speaking gives a positive tone to your voice. Unkempt hair or unwashed uniforms all send a message that you don't want associated with patient care. You may need to make a provision in your budget for a uniform allowance for your staff if they are not presenting a clean team look. Don't be afraid to challenge inappropriate jewelry or make-up and set a standard for a look that makes you proud to present your representatives. Loud voices, the use of obscenities, even in the employee kitchen, should be prohibited. Your office is dedicated to meeting patient needs and your employees all participate in the daily theatre for this goal.
Advise all employees that a clean, well kept office is everyone's responsibility. A piece of paper on the floor won't wait. Coffee pots and refrigerators should be cleaned daily, along with the restrooms, and if it takes a schedule to make it happen, then create a schedule and make sure it is followed. If your practice is doing well financially, consider hiring a cleaning person that comes in for a few hours each morning or evening. Not only will this be a marketing plus, it will also assure that germs are taken care of right away and lessen sick absences. If you cannot afford a professional, invest in some cleaning products, mops, brooms, and a good vacuum and make sure they are put to good use.
In short, put your best foot forward before venturing into the outside world. Every employee in your practice is involved in its marketing each and every day. It is your responsibility to assure that all staff members are doing their best.
Wednesday, July 20, 2011
Marketing Your Medical Practice
Most physicians would appreciate an influx of new patients to offset today's changes in reimbursement. Even physicians with a solid patient base, in a busy demographic area could use the higher reimbursement rates and referrals that are associated with a new patient visit.
Yet, most physicians would be surprised to find that many prospective patients in their immediate demographic area have no idea that their practice even exists. Curbside practices have the advantage of foot and drive by traffic, but even those practices may remain invisible unless the physician reaches out.
Some doctors feel that direct patient marketing carries a negative connotation and would rather rely on referrals from colleagues, family and friends to make their practice more successful. However, medicine is entering an age where consumer savvy baby boomers will be making more of their own health care decisions. This population will have a better understanding of the health care marketplace than prior generations and will not be afraid to challenge decisions made by their physicians or to shop around for the physician that best suits their needs.
Marketing directly to patients and to other prospective health care providers is an excellent tool to maintain a direct communication to your community. The process can be both enjoyable as well as rewarding and will assure that patients and physicians in your area are aware of the services that your provide. In addition, marketing campaigns and the development of associated materials can be a great motivational tool for your professional and clerical staff. Hidden away inside each medical practice are staff members that love to write, draw, or create computer graphics. Tapping into these resources often allows you to run with your marketing ideas and still keep costs within the practice budget. The process is easier than you might imagine and certainly more cost effective than services offered by a professional advertising agency.
What is successful marketing? There are no steadfast rules to developing a successful marketing strategy. At the core of every good campaign is the steady flow of ideas coupled with a motivated staff to make these ideas a reality.
Even the best advertising agencies can create campaigns for your practice that fall short of achieving consumer interest. When you assess the cost of a thirty second television spot and realize how few of these interest the general population, you come to the inevitable conclusion that marketing is basically throwing many ideas up in the air and determining which ones stick to the ceiling and which fall to the ground. Your goal in medical marketing is to share your practice mission with members of your community and to attract patients to services and treatment options that your practice provides. At the end of every campaign, you should feel confident that you reached as many members of the community as possible and that this community has a clear cut understanding of your practice.
How do you start a marketing campaign? The first step in marketing your office should be the creation of practice brochure. Yours can be a simple one page foldout or a more elaborate design, depending on the size of your practice, your budget, and the number of services that your provide.
Your practice brochure should contain the following:
Your mission statement describing your dedication to providing the best in medical care for your patients.
An introduction to the physicians in your practice, noting their qualifications and specialties and Board Certifications.
A brief description of each procedure or special service that your provide.
Your office address (s), phone and fax numbers.
Directions to your location(s).
Any age limitations for your services.
Consider shopping internet artwork for the front of your brochure. There are literally thousands of graphics that are free to download. Whatever you choose, keep the front of your brochure as simple as possible, including a graphic, and the name, address, and phone number of your practice. You may also want one line stating your specialty. Additional office addresses can be listed on the back cover.
If your office is equipped with a state of the art copier, your brochure can be printed in house on glossy or bond paper and still have a professional appearance, while keeping your costs in line. Choose uncomplicated fonts and make sure the brochure is easy to read and not overcrowded with print. Avoid loud colors when choosing your paper. A white brochure with a neat bold font is often the most effective and presents a professional appearance. Remember that this brochure is an introduction to your practice and should be prepared with both patients and prospective referring physicians in mind.
Should you decide to utilize a printing service for your brochure, make sure that more than one proofread is done before you submit the work for final print. Editing errors will cost you additional funds and you will be charged full price for any work performed by the publisher if these errors are not corrected before the brochure is printed.
You should already have an adequate supply of business and appointment cards for your practice. If you are considering using a folder with a pre-made card holder for sending marketing materials to referring physicians, you will want to choose colors and textures that compliment your brochure. Keep all marketing materials consistent to color and texture to present the most professional appearance. When preparing marketing materials for possible referring physicians, you may want to consider adding a referral pad where referring providers can check off what services they want you to provide for their patients. This material will increase the number of referrals and make the process easier for the referring provider.
Make sure that your practice brochure is available and visible at your front desk. If you mail out your new patient registration paperwork in advance of the patient appointment, you should include a practice brochure as well as an appointment card and directions to your office.
There are several companies that are solely dedicated to providing mailing lists that cover every possible demographic in your immediate and close-by communities. You can tailor your list by patient age, sex, number of households with children, and almost any other specific demographic that covers your practice needs. The lists are relatively inexpensive and you may want to begin your basic marketing strategy with a general mailer to homes in your immediate area. Sending a practice brochure to patient who have not returned to your office in some time may also remind these patients that your are still active in your community and may be effective for return visits.
Many medical software systems come equipped with print outs designed to provide patients with a more detailed description of their diagnosis or of future procedures scheduled in your office. Patients appreciate this effort and they often assist in alleviating patient fears. This information can also help reduce the number of phone calls by answering the patients questions in advance. You can also create these types of materials in house as well. In addition, many companies offer pre-printed patient information booklets that can be purchased in bulk. Check online pricing and delivery information in your area and choose the best options for your practice.
Tomorrow - Internal and External Marketing
Yet, most physicians would be surprised to find that many prospective patients in their immediate demographic area have no idea that their practice even exists. Curbside practices have the advantage of foot and drive by traffic, but even those practices may remain invisible unless the physician reaches out.
Some doctors feel that direct patient marketing carries a negative connotation and would rather rely on referrals from colleagues, family and friends to make their practice more successful. However, medicine is entering an age where consumer savvy baby boomers will be making more of their own health care decisions. This population will have a better understanding of the health care marketplace than prior generations and will not be afraid to challenge decisions made by their physicians or to shop around for the physician that best suits their needs.
Marketing directly to patients and to other prospective health care providers is an excellent tool to maintain a direct communication to your community. The process can be both enjoyable as well as rewarding and will assure that patients and physicians in your area are aware of the services that your provide. In addition, marketing campaigns and the development of associated materials can be a great motivational tool for your professional and clerical staff. Hidden away inside each medical practice are staff members that love to write, draw, or create computer graphics. Tapping into these resources often allows you to run with your marketing ideas and still keep costs within the practice budget. The process is easier than you might imagine and certainly more cost effective than services offered by a professional advertising agency.
What is successful marketing? There are no steadfast rules to developing a successful marketing strategy. At the core of every good campaign is the steady flow of ideas coupled with a motivated staff to make these ideas a reality.
Even the best advertising agencies can create campaigns for your practice that fall short of achieving consumer interest. When you assess the cost of a thirty second television spot and realize how few of these interest the general population, you come to the inevitable conclusion that marketing is basically throwing many ideas up in the air and determining which ones stick to the ceiling and which fall to the ground. Your goal in medical marketing is to share your practice mission with members of your community and to attract patients to services and treatment options that your practice provides. At the end of every campaign, you should feel confident that you reached as many members of the community as possible and that this community has a clear cut understanding of your practice.
How do you start a marketing campaign? The first step in marketing your office should be the creation of practice brochure. Yours can be a simple one page foldout or a more elaborate design, depending on the size of your practice, your budget, and the number of services that your provide.
Your practice brochure should contain the following:
Your mission statement describing your dedication to providing the best in medical care for your patients.
An introduction to the physicians in your practice, noting their qualifications and specialties and Board Certifications.
A brief description of each procedure or special service that your provide.
Your office address (s), phone and fax numbers.
Directions to your location(s).
Any age limitations for your services.
Consider shopping internet artwork for the front of your brochure. There are literally thousands of graphics that are free to download. Whatever you choose, keep the front of your brochure as simple as possible, including a graphic, and the name, address, and phone number of your practice. You may also want one line stating your specialty. Additional office addresses can be listed on the back cover.
If your office is equipped with a state of the art copier, your brochure can be printed in house on glossy or bond paper and still have a professional appearance, while keeping your costs in line. Choose uncomplicated fonts and make sure the brochure is easy to read and not overcrowded with print. Avoid loud colors when choosing your paper. A white brochure with a neat bold font is often the most effective and presents a professional appearance. Remember that this brochure is an introduction to your practice and should be prepared with both patients and prospective referring physicians in mind.
Should you decide to utilize a printing service for your brochure, make sure that more than one proofread is done before you submit the work for final print. Editing errors will cost you additional funds and you will be charged full price for any work performed by the publisher if these errors are not corrected before the brochure is printed.
You should already have an adequate supply of business and appointment cards for your practice. If you are considering using a folder with a pre-made card holder for sending marketing materials to referring physicians, you will want to choose colors and textures that compliment your brochure. Keep all marketing materials consistent to color and texture to present the most professional appearance. When preparing marketing materials for possible referring physicians, you may want to consider adding a referral pad where referring providers can check off what services they want you to provide for their patients. This material will increase the number of referrals and make the process easier for the referring provider.
Make sure that your practice brochure is available and visible at your front desk. If you mail out your new patient registration paperwork in advance of the patient appointment, you should include a practice brochure as well as an appointment card and directions to your office.
There are several companies that are solely dedicated to providing mailing lists that cover every possible demographic in your immediate and close-by communities. You can tailor your list by patient age, sex, number of households with children, and almost any other specific demographic that covers your practice needs. The lists are relatively inexpensive and you may want to begin your basic marketing strategy with a general mailer to homes in your immediate area. Sending a practice brochure to patient who have not returned to your office in some time may also remind these patients that your are still active in your community and may be effective for return visits.
Many medical software systems come equipped with print outs designed to provide patients with a more detailed description of their diagnosis or of future procedures scheduled in your office. Patients appreciate this effort and they often assist in alleviating patient fears. This information can also help reduce the number of phone calls by answering the patients questions in advance. You can also create these types of materials in house as well. In addition, many companies offer pre-printed patient information booklets that can be purchased in bulk. Check online pricing and delivery information in your area and choose the best options for your practice.
Tomorrow - Internal and External Marketing
Tuesday, July 19, 2011
Politics and the Inevitable Decline of the Community Hospital
If you pay close enough attention to the executive staff at some community hospitals, you can't help but notice that every few years they seem to have a new C.E.O. or C.O.O. or some other honcho at the top. Whenever I see this trend the first thing that pops into my mind is "Politics."
Although, some clawing your way to the top is to be expected in all corporations and management is prey to "better dealing," I believe that this trend signals a bigger issue and poses a serious danger to the survival of hospitals in general, small community hospitals in particular.
The real issue is not so much the back biting of politics but rather where the political climate leads. I have seen some hospitals where "just perfect" is the catch phrase of the day. Picture a board meeting with the heads of the various departments seated around an oblong table and one by one each department head presenting a report for a new business venture. "Billing?" "Great!" "IT?" "Great!" Etc. etc. etc.
Round and round each member of management making sure that no boat was rocked and NO problem was addressed.
Unfortunately, this is the consequence of the political life - making sure that CYA is taken to the extreme, hiding out to protect your job at the cost of making significant changes that would increase revenue. Playing "nice, nice" with the big boys at the top. Believe me, you would never see a successful private practice using these tactics - you would never see any successful private corporation believe that issues be hidden under the table. Small community hospitals are taking a big hit these days and have a large bitter pill to swallow with all the changes in reimbursement and coding that is coming their way. Larger hospital corporations are gobbling up these harbors of the community like small fish in a big fish pond, and soon their very existence will be a thing of the past.
Another huge error in the community hospital is promoting the nursing staff to positions outside of medicine or even within hospital based practices. My sister has been a nurse for thirty years, and I am well aware of the overwhelming responsibilities of this profession. In todays' market, every hospital is understaffed and nurses are inundated with paperwork and an exploding, less tolerant patient population.
This does not mean, however, that we allow nurses, with little to no administrative experience in managing a private office, or directing telecommunications, to head these departments. I have seen nurses, working on their Masters degrees, trying to juggle the day to day administrative tasks of a medical practice and fail miserably. There is a different skill set needed to be a brilliant nurse than there is to be a brilliant administrator. Unless you are equipped with the complete package or are pursing a career in Health Care Administration, your nursing staff should move up the ranks in the areas of their special talents.
Our hospitals are soon to be judged and reimbursed on patient satisfaction scores. It is time for us to stop believe our own press releases, and to bring our specific problems to the table and make sure that they are addressed. In a large urban setting or a small community hospital there is certainly enough talent to carry us successfully forward into this uncertain future. Less politics, more truth, and hard work are the skill sets we need to cultivate.
Although, some clawing your way to the top is to be expected in all corporations and management is prey to "better dealing," I believe that this trend signals a bigger issue and poses a serious danger to the survival of hospitals in general, small community hospitals in particular.
The real issue is not so much the back biting of politics but rather where the political climate leads. I have seen some hospitals where "just perfect" is the catch phrase of the day. Picture a board meeting with the heads of the various departments seated around an oblong table and one by one each department head presenting a report for a new business venture. "Billing?" "Great!" "IT?" "Great!" Etc. etc. etc.
Round and round each member of management making sure that no boat was rocked and NO problem was addressed.
Unfortunately, this is the consequence of the political life - making sure that CYA is taken to the extreme, hiding out to protect your job at the cost of making significant changes that would increase revenue. Playing "nice, nice" with the big boys at the top. Believe me, you would never see a successful private practice using these tactics - you would never see any successful private corporation believe that issues be hidden under the table. Small community hospitals are taking a big hit these days and have a large bitter pill to swallow with all the changes in reimbursement and coding that is coming their way. Larger hospital corporations are gobbling up these harbors of the community like small fish in a big fish pond, and soon their very existence will be a thing of the past.
Another huge error in the community hospital is promoting the nursing staff to positions outside of medicine or even within hospital based practices. My sister has been a nurse for thirty years, and I am well aware of the overwhelming responsibilities of this profession. In todays' market, every hospital is understaffed and nurses are inundated with paperwork and an exploding, less tolerant patient population.
This does not mean, however, that we allow nurses, with little to no administrative experience in managing a private office, or directing telecommunications, to head these departments. I have seen nurses, working on their Masters degrees, trying to juggle the day to day administrative tasks of a medical practice and fail miserably. There is a different skill set needed to be a brilliant nurse than there is to be a brilliant administrator. Unless you are equipped with the complete package or are pursing a career in Health Care Administration, your nursing staff should move up the ranks in the areas of their special talents.
Our hospitals are soon to be judged and reimbursed on patient satisfaction scores. It is time for us to stop believe our own press releases, and to bring our specific problems to the table and make sure that they are addressed. In a large urban setting or a small community hospital there is certainly enough talent to carry us successfully forward into this uncertain future. Less politics, more truth, and hard work are the skill sets we need to cultivate.
Monday, July 18, 2011
Sweat The Details
There are many physicians who believe that the business end of their practice will simply run itself. Their job is to see patients, and provide medical care and the rest of their shop is left to the staff, without any intervention at all. Other physicians micro-mange their practice to death, so they are left doing everything and their staff may as well be mannequins, since they never have the support or initiative to solve any problems on their own.
Both of these situations do great damage to the practice and doctors must find a balance between apathy and complete control. It is very important to take a careful look at the outer edges of the day to day operations, since you can be assured that your practice will be in great danger unless this situation is addressed.
A few years ago I took a position in a large Long Island hospital with a great reputation for patient care. My job was to oversee the billing department and to assess why the physician's revenue stream was declining. The practice had purchased a new medical software in 2004 and as part of their purchase agreement allowed the software seller to perform the billing data entry and accounts receivable follow up. As always, my first step was to run an accounts receivable and make a careful examination of practice billing trends. What I discovered was unbelievable ! From 2004 until the start of my tenure in 2007, the practice had not been paid for 1 claim for their nurse practitioners who followed patients in the hospital post cath and bypass surgery. Not 1 claim !!!!! Why? In the set up of the new software, nurse practitioners were entered into the system with their social security numbers, rather than the practice Tax ID. No one had noticed, either in house or through the billing department. Not 1 claim was paid for the radioactive isotopes used in Nuclear Stress Testing ! Not 1 claim ! Why? The description for the isotope was not standard for CMS approval so all claims were denied. In addition, 2 physicians were transmitting claims with the same NPI number, also resulting in claim denial!
These problems resulted in hundreds of thousands of dollars in write offs for timely filing and the consequences of these errors would be felt in practice revenue for some time. Eventually, I was able to correct these problems, but you cannot fix the mentality behind them. There needs to be a vested interest in the practice that involves checking the details over and over again until you are certain that your data is correct and your claims will be paid. Print out your HCFA's and examine each physician detail and use resource materials if you are not sure how your information should be entered. If you think this is an isolated incident you are sadly mistaken.
Simply transposing a physicians Medicare or commercial ID number can result in a disaster for the practice and in a single physician practice, you may lose everything! This is what happens when any physician simply shrugs off the danger signs or doesn't educate themselves, or trusts their practice to staff that doesn't have enough information or education to assure success. Physicians need to know that their office is a business and they need to arm themselves with enough information to run this business correctly or look for another career ! There is absolutely no excuse for practicing medicine year after year and claiming ignorance of what makes a practice work.. Once your staff knows that you have no idea of what's going on in your business, you can rest assured that they will adopt the same apathetic attitude that you have. For those employees who want a productive active day and who would add value to your practice, you can expect their resignation shortly after their start date. Staff can sniff out a practice that's a loser in one week and will either ride the tide until the practice closes, or they will look for another job.
Your patients will also read the climate of your room and if your staff is apathetic and doesn't return phone calls, or make timely appointments, they will bolt for the nearest exit and you will never see them again.
In this healthcare climate, where vendors are rushing to market with sub-standard software, where the unemployment rate is at an all time high, and cut backs and changes are like a great flood, all practices are finding themselves in a sink or swim situation.
The decision to survive is up to you....
Both of these situations do great damage to the practice and doctors must find a balance between apathy and complete control. It is very important to take a careful look at the outer edges of the day to day operations, since you can be assured that your practice will be in great danger unless this situation is addressed.
A few years ago I took a position in a large Long Island hospital with a great reputation for patient care. My job was to oversee the billing department and to assess why the physician's revenue stream was declining. The practice had purchased a new medical software in 2004 and as part of their purchase agreement allowed the software seller to perform the billing data entry and accounts receivable follow up. As always, my first step was to run an accounts receivable and make a careful examination of practice billing trends. What I discovered was unbelievable ! From 2004 until the start of my tenure in 2007, the practice had not been paid for 1 claim for their nurse practitioners who followed patients in the hospital post cath and bypass surgery. Not 1 claim !!!!! Why? In the set up of the new software, nurse practitioners were entered into the system with their social security numbers, rather than the practice Tax ID. No one had noticed, either in house or through the billing department. Not 1 claim was paid for the radioactive isotopes used in Nuclear Stress Testing ! Not 1 claim ! Why? The description for the isotope was not standard for CMS approval so all claims were denied. In addition, 2 physicians were transmitting claims with the same NPI number, also resulting in claim denial!
These problems resulted in hundreds of thousands of dollars in write offs for timely filing and the consequences of these errors would be felt in practice revenue for some time. Eventually, I was able to correct these problems, but you cannot fix the mentality behind them. There needs to be a vested interest in the practice that involves checking the details over and over again until you are certain that your data is correct and your claims will be paid. Print out your HCFA's and examine each physician detail and use resource materials if you are not sure how your information should be entered. If you think this is an isolated incident you are sadly mistaken.
Simply transposing a physicians Medicare or commercial ID number can result in a disaster for the practice and in a single physician practice, you may lose everything! This is what happens when any physician simply shrugs off the danger signs or doesn't educate themselves, or trusts their practice to staff that doesn't have enough information or education to assure success. Physicians need to know that their office is a business and they need to arm themselves with enough information to run this business correctly or look for another career ! There is absolutely no excuse for practicing medicine year after year and claiming ignorance of what makes a practice work.. Once your staff knows that you have no idea of what's going on in your business, you can rest assured that they will adopt the same apathetic attitude that you have. For those employees who want a productive active day and who would add value to your practice, you can expect their resignation shortly after their start date. Staff can sniff out a practice that's a loser in one week and will either ride the tide until the practice closes, or they will look for another job.
Your patients will also read the climate of your room and if your staff is apathetic and doesn't return phone calls, or make timely appointments, they will bolt for the nearest exit and you will never see them again.
In this healthcare climate, where vendors are rushing to market with sub-standard software, where the unemployment rate is at an all time high, and cut backs and changes are like a great flood, all practices are finding themselves in a sink or swim situation.
The decision to survive is up to you....
Friday, July 15, 2011
Reinforce The Message
A quarterly assessment of your staff's success will allow you to properly gauge your practice's human resource needs. You may find that a particular job can be accomplished on a part time basis and then restructure your needs accordingly. You can also consider giving some ancillary personnel the option of unpaid time off whenever physicians are on vacation or conferences, or in slower periods during the year. Often employees are more than willing to take some unpaid time and will jump at the chance for an extra week off during the year. This option will help avoid practice burn out, which seems to be an ever increasing side effect of working in a medical office. At any rate, it will help you to conserve revenue and give your employees something to look forward to at certain times of the year.
Meetings : Every practice should schedule a quarterly meeting where members of the professional and management staff are in attendance. The meeting should address the strengths and weaknesses of the office for each quarter, by examining the number of new and return patients, the number of procedures performed, and collected practice revenue for each location. Comparisons should be noted and any reason for decline in revenue should be immediately addressed. Often trends continue in a downward spiral if they are not properly addressed and carefully examined. There may be an error in your billing system or a problem with your credentialing with Medicare or the commercial insurers.
In addition to meeting expectations each quarter, office equipment, and marketing needs should be analyzed and clear plans for forward growth should be outlined. The office manager should present significant statistical data to physicians and staff and a future plan for each department should be part of this agenda. Don't forget that your practice is a corporation and should be subject to the same analysis as any other business looking toward future growth and continued success.
Meetings : Every practice should schedule a quarterly meeting where members of the professional and management staff are in attendance. The meeting should address the strengths and weaknesses of the office for each quarter, by examining the number of new and return patients, the number of procedures performed, and collected practice revenue for each location. Comparisons should be noted and any reason for decline in revenue should be immediately addressed. Often trends continue in a downward spiral if they are not properly addressed and carefully examined. There may be an error in your billing system or a problem with your credentialing with Medicare or the commercial insurers.
In addition to meeting expectations each quarter, office equipment, and marketing needs should be analyzed and clear plans for forward growth should be outlined. The office manager should present significant statistical data to physicians and staff and a future plan for each department should be part of this agenda. Don't forget that your practice is a corporation and should be subject to the same analysis as any other business looking toward future growth and continued success.
Thursday, July 14, 2011
Your Chain of Command
When a practice creates a workplace where departments are answerable and responsible to each other, they not only have the ability to double check the accuracy of the work, but also to reinforce the idea that the practice functions as a single unit with a team mentality.
Your chain of command will appear as follows: The Medical Director or senior partner establishes the mission statement for the practice and all employees are directly answerable to this individual. He or she will meet each month with their department heads and should expect a full report on the functionality of the department along with a listing of any emergent problems so that they can be immediately addressed.
The Administrator or office manager assures that each department adheres to the practice guidelines in order to realize the mission statement goals. The administrator will staff the practice with employees that promise to excel in their job descriptions, keep true to the idea of a team mentality and practice in an atmosphere of courtesy and professionalism where patients are the number one priority.
Department managers, including those assigned to the clinical staff will report to the administrator, supervise and evaluate their employees and form relationships with each department within the practice. Their goal is to make sure that each department is equipped with the resources and skills that are needed to realize both individual and practice goals.
Professional Staff : Members of your professional staff should be contracted employees with job descriptions and practice expectations clearly outlined. Any professional contract should also include a request for generous notice should these employees terminate their agreement. Losing an echo technician or a physician assistant without adequate time for replacement can result in months of lost revenue and a disruption in the patient schedule.
Prepare your practice with adequate coverage in the event of illness or family emergencies. There are a number of temporary agencies that can supply you with per-diem employees in cases where a member of your team will be absent. You will want to familiarize yourself with these agencies long before an emergency presents itself. Check to make sure that your office insurance policy provides per-diem coverage for this situation or that the agency has its own coverage that can apply to your facility.
Vacations and sick-personal time should be clearly noted in the contracts of your professional employees. In some cases, you may be willing to offer additional vacation time as leave without pay if you find that there are quarters during the calendar year where your practice has less visits. A well qualified health care attorney should prepare all of your employee contracts and you should have a clear notion of any bonus structures prior to hiring. Often new physicians entering an established practice are more interested and eager to meet the bonus structure requirements and will entertain a smaller base pay for their first year or two. The bonus structure offered, should be dependent not only on the performance of the physician but also on the annual practice overhead. With constant changes to reimbursement and the rising cost of maintaining the practice, overhead can fluctuate drastically from year to year. Most physicians are less than optimistic about the immediate future of healthcare so structuring your bonus package to balance earnings minus shared overhead has proven to be the formula that works best for most offices. Providing this information to new physician hires well in advance will alleviate unnecessary resentments and disappointment.
Tomorrow: Reinforce the Message
Your chain of command will appear as follows: The Medical Director or senior partner establishes the mission statement for the practice and all employees are directly answerable to this individual. He or she will meet each month with their department heads and should expect a full report on the functionality of the department along with a listing of any emergent problems so that they can be immediately addressed.
The Administrator or office manager assures that each department adheres to the practice guidelines in order to realize the mission statement goals. The administrator will staff the practice with employees that promise to excel in their job descriptions, keep true to the idea of a team mentality and practice in an atmosphere of courtesy and professionalism where patients are the number one priority.
Department managers, including those assigned to the clinical staff will report to the administrator, supervise and evaluate their employees and form relationships with each department within the practice. Their goal is to make sure that each department is equipped with the resources and skills that are needed to realize both individual and practice goals.
Professional Staff : Members of your professional staff should be contracted employees with job descriptions and practice expectations clearly outlined. Any professional contract should also include a request for generous notice should these employees terminate their agreement. Losing an echo technician or a physician assistant without adequate time for replacement can result in months of lost revenue and a disruption in the patient schedule.
Prepare your practice with adequate coverage in the event of illness or family emergencies. There are a number of temporary agencies that can supply you with per-diem employees in cases where a member of your team will be absent. You will want to familiarize yourself with these agencies long before an emergency presents itself. Check to make sure that your office insurance policy provides per-diem coverage for this situation or that the agency has its own coverage that can apply to your facility.
Vacations and sick-personal time should be clearly noted in the contracts of your professional employees. In some cases, you may be willing to offer additional vacation time as leave without pay if you find that there are quarters during the calendar year where your practice has less visits. A well qualified health care attorney should prepare all of your employee contracts and you should have a clear notion of any bonus structures prior to hiring. Often new physicians entering an established practice are more interested and eager to meet the bonus structure requirements and will entertain a smaller base pay for their first year or two. The bonus structure offered, should be dependent not only on the performance of the physician but also on the annual practice overhead. With constant changes to reimbursement and the rising cost of maintaining the practice, overhead can fluctuate drastically from year to year. Most physicians are less than optimistic about the immediate future of healthcare so structuring your bonus package to balance earnings minus shared overhead has proven to be the formula that works best for most offices. Providing this information to new physician hires well in advance will alleviate unnecessary resentments and disappointment.
Tomorrow: Reinforce the Message
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